PDF(Pubmed)
Abstract：
Background and objectives: Colorectal cancer is a major global health concern, with a significant increase in morbidity and mortality rates associated with metastatic stages. This study investigates the prognostic significance of various clinical and laboratory parameters in patients with metastatic CRC. Materials and Methods: A retrospective cohort of 188 CRC patients with hepatic metastasis from the OncoHelp Association in Timisoara was analyzed from January 2016 to March 2023. Data on demographics, clinical characteristics, and biomarkers, such as lymphocyte counts, as well as various inflammation indices, were examined. Statistical analyses included univariate and multivariate logistic regression, Kaplan-Meier survival analysis, and ROC curve assessments. Results: Our findings indicate significant associations between survival outcomes and several biomarkers. Higher BMI and lymphocyte counts were linked with better survival rates, while higher values of Neutrophil-Hemoglobin-Lymphocyte (NHL) score, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) were predictors of poorer outcomes. Notably, the presence of hepatic metastasis at diagnosis was a critical factor, significantly reducing overall survival. Conclusions: The study has expanded the current understanding of prognostic factors in CRC, advocating for a multi-dimensional approach to prognostic evaluations. This approach should consider not only the traditional metrics such as tumor stage and histological grading but also incorporate a broader spectrum of biomarkers. Future studies should aim to validate these findings and explore the integration of these biomarkers into routine clinical practice, enhancing the precision of prognostic assessments and ultimately guiding more personalized treatment strategies for CRC patients.
摘要：
背景和目标：结直肠癌是全球主要的健康问题，与转移阶段相关的发病率和死亡率显着增加。这项研究调查了转移性CRC患者各种临床和实验室参数的预后意义。材料和方法：2016年1月至2023年3月，回顾性队列分析了来自TimisoaraOncoHelp协会的188例CRC肝转移患者。人口统计数据，临床特征,和生物标志物，如淋巴细胞计数，以及各种炎症指标，进行了检查。统计分析包括单变量和多变量逻辑回归，Kaplan-Meier生存分析，和ROC曲线评估。结果：我们的发现表明生存结果与几种生物标志物之间存在显著关联。较高的BMI和淋巴细胞计数与较高的生存率有关，而中性粒细胞-血红蛋白-淋巴细胞（NHL）评分较高，中性粒细胞-淋巴细胞比率（NLR），血小板-淋巴细胞比率(PLR),和全身免疫炎症指数（SII）是预后较差的预测因子。值得注意的是,诊断时肝转移的存在是一个关键因素，显著降低总生存率。结论：该研究扩大了目前对CRC预后因素的认识，倡导多维度的预后评估方法。这种方法不仅要考虑传统的指标，如肿瘤分期和组织学分级，而且要考虑更广泛的生物标志物。未来的研究应旨在验证这些发现，并探索将这些生物标志物整合到常规临床实践中。提高预后评估的准确性，并最终指导更个性化的CRC患者治疗策略。
